Michelle Hewitt has spent years raising concerns about medical assistance in dying (MAID).
So she never expected to become a widow because of it.
Hewitt has lived with multiple sclerosis for nearly two decades. As board chair of the advocacy organization Disability Without Poverty, she hears regularly from people with disabilities who consider MAID because of poverty, insufficient medical care or social support.
But when Hewitt’s husband, Victor Enns, wanted to die by MAID, she set her objections aside and chose to support him.
“That’s one of the hardest decisions I’ve ever made,” she said in February.
Hewitt, who lost her husband to MAID in December, says that supporting Enns was the right choice.
“I still believe it’s the right decision.”
But the process by which he was approved for MAID has reinforced — and increased — her concerns.
“It was easier for Victor to get MAID than it was for him to get anything else,” she said. “I just don’t believe that that’s how it should be.”
Whirlwind romance
Enns and Hewitt always knew death would enter their marriage sooner rather than later.
When they met in January 2021, she was 53, he was 65. She was recently widowed for the second time and he divorced for the third. Neither wanted to waste time.
And they didn’t. Enns’ four-word introduction on a disability-focused social networking site — “I like your hair” — quickly led to lengthy emails then video calls.
He was in Gimli, Man., she was in Kelowna, B.C. They shared meals over video calls timed around medication schedules.
In April 2021, Enns flew to Kelowna. The plan was to spend two weeks together. Instead, he returned to Manitoba only once, to refill prescriptions. They wed in August of that year.
Enns wrote the officiant’s introduction to their vows.
“You have learned from your own experiences and from each other, suffering is unavoidable, real and to be believed,” Enns wrote. “And [you] know to offer each other succor and consolation when tears fall and times are hard.”
Neither knew how difficult that would be.
Medical crises
Moving to B.C. was risky for Enns. It meant leaving his longtime doctors behind.
Enns had struggled with chronic pain and depression for decades. Throughout his life, he had often felt disbelieved by the medical establishment. His amputated left leg was the clearest example. He had had to convince doctors that an amputation was the only way to end the searing pain in his leg, the result of a failed foot fusion surgery and severe osteoarthritis.
After that surgery, pain continued, just elsewhere in his body.
In B.C., Enns found a family doctor quickly: a woman who, coincidentally, had attended school with one of Enns’ sons. But in 2022 she moved, and he needed to find a new family doctor to prescribe painkillers.
Enns was caught in the crossfire of two health crises: a provincial opioid epidemic and a national doctor shortage. The only B.C. doctor who would prescribe painkillers was an addiction specialist. For the rest of his life, Enns felt he was labelled as an addict.
He received a prescription for methadone, a new drug for him. It was too much. He almost died and was put in a medically induced coma so doctors could stabilize him.
Once released, his memory and motivation to leave his home diminished. He began sleepwalking. He once poured boiling water on himself while asleep; another time, he fell after attempting to walk without a prosthetic.
Emergency room doctors told Enns and Hewitt nothing was wrong. Hewitt says they were told Enns was at-risk of being flagged as a patient who fabricated stories.
Enns wanted to receive an opioid his former family doctor had prescribed. It gave him fair control of his pain, he said. But doctors refused, noting they were concerned it could kill him.
Funeral march begins
In August 2024, Enns woke Hewitt from her daily afternoon nap to say the pain in his left shoulder was unbearable.
He wanted MAID.
Hewitt was not completely surprised. She could hear his shoulder bones grind against each other all the time. “It was the percussion section in his shoulder,” she said.
But this was not the music of a lively rock band. The pain was keeping time to a funeral march.
Hewitt knew her husband would not waver in his decision to get MAID. So she put her advocacy work aside and set about supporting him.
For Enns, MAID was the right choice, she says. But not because it reinforced his dignity.
“It was empowering in that it was the only thing that Victor could take control of,” she said in February. “It was the only thing left.”
Pain increases
When Enns announced he wanted MAID, he was on the waitlist for shoulder surgery. Hewitt called his surgeon immediately to explain the urgency of the situation. A spot had recently opened, and Enns had surgery five days later.
The recovery went well. But it magnified Enns’ other pain.
“It was like he actually started feeling the rest of all the pain that he was carrying that this [shoulder] pain was muting a little bit,” said Davina Kula, a personal care worker who worked with Enns and Hewitt since 2022.
Enns slept in a medical recliner because searing back pain made lying down impossible. The percussive pain was now in his knee.
Kula understood why Enns felt dismissed by the medical system. At appointments with Enns and Hewitt, doctors often first directed questions to Kula. “It feels like his [medical] issues got minimized quite a bit,” Kula said.
Enns was diagnosed with dementia in April 2025.
After this, his desire to obtain MAID swung into high gear.
“I felt like we were talking about MAID every day,” said Kula. Spilled food, dropped items, missed words all prompted Enns to discuss MAID.
Hewitt was conflicted. The man she had vowed to love in sickness and in health, till death did them part, was pursuing a method of death she opposed.
Yet, she wanted his suffering to end.
This was no regular dying process. When her previous husbands had been diagnosed with cancer, they had always remained hopeful for a cure.
There was no such hope with MAID. “Death was there constantly,” she said.
‘Blurry’ lines
In July, Enns had the first of two medical assessments needed to determine if he was legally eligible for MAID.
He worried about forgetting details or not being believed. Hewitt helped prepare notes for him.
They were ultimately not necessary.
At the first assessment, the assessor told Enns he was approved shortly after Enns began telling his story. The second assessor began the assessment by telling Enns he was approved.
“They were so fast. They weren’t worth talking about,” Enns said in December, five days before he died.
Both assessments worried Hewitt.
Under Canadian law, MAID patients are approved as either Track 1 or Track 2. Track 1 means their death is reasonably foreseeable; Track 2 means their death is not.
Hewitt had assumed Enns would qualify as Track 2 MAID. But assessors told him he could be Track 1, because of his dementia diagnosis.
Hewitt had previously lost two husbands to cancer. She felt she knew what dying looks like, and that Enns was not dying, even though he was diagnosed with dementia.
“I thought that I could clearly identify a Track 1 MAID person,” she said in February. “Clearly I can’t.”
Dementia has proven controversial in MAID requests.
A report released last fall by the Ontario MAID Death Review Committee described several cases where dementia patients were approved for Track 1 MAID. In many cases, individuals were recently diagnosed and were struggling with fear of the future. Committee members, many of whom were doctors or nurses, disagreed with each other about whether MAID assessments for dementia patients require more rigour.
Under federal law, each MAID death must be reported to Health Canada, and reports must indicate if patients were Track 1 or Track 2.
But Enns and Hewitt did not know what track Enns was approved under. Hewitt says the assessors never told them.
A patient’s track affects how they are treated. Track 2 patients are supposed to be informed of counselling, disability and community supports that could relieve their suffering.
Enns did not receive any such offers, Hewitt says. In fact, there was such little communication after the MAID approval that Enns began to worry doctors had forgotten about his scheduled death.
For Hewitt, the experience increased her concerns about MAID. She had had concerns about Track 2 since it was legalized in 2021. Now, she had concerns about Track 1 as well.
“If the lines between Track 1 and Track 2 are so blurry, I now have strong doubts about Track 1,” she said.
‘That’s enough’
But Enns was at peace with his decision.
“I’m going to, to die,” he said in December, five days before his death.
“I’m 70 years old. I’m not a babe in the woods or anything like that. I’ve had different kinds of pain and mental health issues for 50 years.” He looked down, his voice cracking. “I think that’s enough. That’s really what it is.”
The dementia was also robbing his comprehension, the ultimate fear for a professional poet like Enns. He struggled to understand poems he had just written for a book to be published posthumously.
“I don’t want to wait until I sound like a fool to myself,” he said, before acknowledging that might sound derogatory.
“Language like that isn’t appropriate for someone with a disability, but that’s how it feels sometimes to me.”
He wanted a good death, he said, and felt MAID was good “compared to some of the other options.”
He knew his physical pain would never truly subside. The dementia was here to stay.
“There’s some things you just can’t fix, no matter how hard you try,” he said.
Hewitt remained troubled by the process.
“I have chosen to support Victor in what he wants, but this journey in itself—” She paused, then turned and spoke to Enns. “It’s not been a good journey for you.”
“Not as good as it could be,” he agreed.
“But really?” He turned to his wife with a laugh. “You expect MAID to be a good journey?”
Final goodbyes
In the end, it was not the good death Enns had wanted.
Enns and Hewitt set about making his last day as memorable as possible. He ate a hearty pancake breakfast with Hewitt and all the caregivers. He had strawberries and maple syrup and a thick milkshake. He was the “life and soul of the party,” Hewitt said.
After a rest, Enns picked his final outfit: dress pants and a dress shirt.
They wheeled in their wheelchairs to the hospice, which could be seen from their condo. They took their time, pausing to watch fish in the pond outside before entering the hospice. In their final photo together, they smiled like newlyweds.
He had asked to not lie down on the bed for very long before the procedure began because of his back pain. That was not to be.
The IV was set about 45 minutes before MAID was to begin. His dress shirt was taken off. Later, they had to reset the IV because it had not been inserted properly. Enns cried in pain as he waited for the medication to take effect.
Hewitt had to leave his side so the IV could be reset. They yelled their final goodbyes to each other from across the room.
Hewitt watched it all, telling him she loved him. Enns said he loved her and his family. Then, it was done.
Hewitt returned to an empty condo, walked her service dog and took a sleeping pill.
She had gone from being a vocal critic of MAID to a MAID widow.
‘Love remains’
Even living under MAID’s long shadow, Enns and Hewitt found joy together.
In the evening, after their care team had left, they ate ice cream, laughing like children gobbling forbidden desserts.
She would describe what happened on her nightly walks with her service dog, and they would end each night by saying the same words together: “We are better together, because we are happy, we are safe and we are very well loved.”
Five days before his death, the affection was obvious. They kissed. They laughed. They hung onto each other’s words; they knew not many words were left.
“I’ve learned he is incredibly strong, to just daily go through the level of pain that he goes [through],” Hewitt said.
“And then to make this decision, and to be fair, going into it knowing that it’s not something that I would have advocated for him to do.”
Enns knew nothing had changed his wife’s love for him.
“I’ve got what I have in your arms right now, and that is that the love remains,” he told her. “That we are still, still —”
She completed his sentence. “Very much in love.”
